Occupational dermatoses

By definition, an occupational dermatosis is a skin disease that develops in the workplace. Occupational dermatoses are a source of discomfort and can affect the quality of life both at work and at home.

How does occupational dermatosis manifest itself?

Most often, occupational dermatosis results in eczema , i.e. the appearance of red, rough and itchy plaques.

This occupational eczema mainly affects the hands, which are central to most professions and activities.

Eczema develops as a result of direct contact between the skin and the irritating and/or allergenic substance. In some cases, eczema is airborne, meaning that the substance is carried by air. This is particularly the case in the food sector, meaning the face can be affected.

What causes occupational dermatitis?

An occupational dermatosis can result from two quite distinct phenomena: irritation on the one hand and allergy on the other. Most of the chemicals involved in occupational dermatitis are both irritating and allergenic. Occupational allergies are very varied; they obviously depend on the job and the chemicals used: hairdressers risk becoming allergic to dyes, carers to antiseptics, and bricklayers to cement. Allergy to detergents is more common among cleaning staff. Contact eczema involves the immune system, which is not the case with irritant dermatitis. As its name suggests, it involves irritating phenomena and can appear in both allergic and non-allergic individuals.

Factors such as atopy, unfavorable climatic conditions (wind, cold, etc.), stress, humidity, act as additional factors of irritation and lead to the appearance of a real chronic hand eczema .

Who is affected by occupational dermatoses?

Anyone can be affected by occupational eczema: the young, the not so young, both those with and without professional experience, and those with or without a history of dermatological conditions. The appearance of an occupational dermatosis in the construction industry does not mean that you are less of a professional than your colleagues on the building site, it is not a sign of weakness, it just means that your skin does not tolerate this or that substance.

How does an occupational dermatosis develop?

One of the characteristics of occupational dermatitis is that it subsides or even disappears during vacations. Contact with irritating and/or allergenic agents is interrupted and the skin feels better... until work is resumed. For example, healthcare personnel eczema is often promoted by repeated hand washing. Hydroalcoholic solutions are less of a source of dermatosis than "classic" hand washing, but repeated use of these solutions can aggravate a pre-existing dermatosis. On vacation, hands are washed less often and regain a normal appearance.

However, over time, chronic hand eczema can persist even during vacations. Unless irritating and/or allergenic factors are identified and drastically avoided, occupational dermatitis continues to develop and cause discomfort.

How should occupational dermatitis be treated?

Chronic hand eczema, whether occupational or non-occupational, is always treated in the same way. Initially, apply a cortisone cream once a day until the lesions disappear. As a second step, emollients help to hydrate the skin but are not applied to eczema plaques. In contrast, medical devices in the form of soothing repair creams have been shown to speed up the treatment of plaques (by applying the repair cream over the topical corticosteroid, like a dressing) and limit their reappearance (by applying the repair cream to areas usually affected by eczema). Finally, the application of an insulating barrier cream in the morning and/or during the day helps protect the skin from aggression or irritation when it cannot be completely avoided.

However, the best way to treat an occupational dermatosis is to avoid the irritating and/or allergenic factors identified with the help of the dermatologist, allergist, attending physician or occupational physician. When this is not possible, occupational dermatosis can be recognized as an occupational disease and lead to the person having to change professions, which can be very difficult to live with. For example, hairdressers' eczema is particularly dreaded because this profession is often a real passion.

How can you avoid occupational dermatitis?

To avoid developing occupational dermatosis and chronic hand eczema, a few simple rules apply in all professions:
  • Wear gloves when handling irritating and/or allergenic substances to prevent them from coming into contact with the skin. Wearing gloves for long periods of time should not make you forget to take care of your hands (see following points);
  • Do not keep hands wet or dirty;
  • Wash hands with lukewarm water and mild soap, dry well;
  • Apply an insulating barrier cream before and during work, then a soothing repair cream after work.
Employers are also involved in the prevention of occupational dermatoses, for example in the choice of products they make available to their employees.

If lesions still appear, it is important to consult a dermatologist quickly to benefit from an effective treatment and appropriate care. The occupational physician is also a resource and essential person in the care pathway.